Organizational Decision Research Articles

Building a Culture of Maintenance: Strategies for Addressing Office Machine Challenges in Polytechnics

This research study was undertaken to investigate the various challenges faced by staff in maintaining office machines, which are critical to the smooth operation of modern workplaces. The study involved a thorough review of existing literature, encompassing both published and unpublished works, to examine the wide array of issues related to the maintenance of office equipment. To gather empirical data, a structured questionnaire comprising 15 items was developed to address three specific research questions. This questionnaire was administered to a sample of 35 staff members from selected polytechnics in the North Western Zone. The data collected from the responses were systematically analysed using the mean method, following a 5-point Likert-type rating scale. The findings were organised and presented in well-structured tables to facilitate understanding and interpretation. The analysis highlighted that one of the most effective measures staff can adopt to prevent breakdowns of office machines is to have a comprehensive understanding of contemporary office equipment and their maintenance needs. Furthermore, the results revealed that a significant contributing factor to the frequent breakdown of these machines is the lack of proactive organisational decisions and comprehensive maintenance policies. Additionally, a marked disinterest in identifying the root causes of equipment failures further exacerbates the challenges faced by staff. Based on these findings, this study recommends that organisations implement a series of conferences, workshops, and training sessions focused on maintenance best practices. Such initiatives would serve to enhance awareness among staff about effective strategies for prolonging the lifespan of office machines. Furthermore, by fostering a culture of proactive maintenance, organisations can significantly reduce their maintenance costs and improve operational efficiency.

Maximum and set covering problem considering the internal structure of production units

Purpose In many real-world problems, this paper faces some production processes that have internal structures that should be taken into account to have a comprehensive analysis. This situation is settled in the network data envelopment analysis (DEA) literature. Therefore, in this article, this paper aims to develop two types of covering location problems joint with network data envelopment analysis. This paper propose biobjective mixed integer programming models associated with the aforementioned development. In the first model, the goal is to select locations of facilities such that the total efficiency score is maximized and the total establishing cost for covering all demands is minimized. In the second model, this paper considers the location of facilities for maximizing the total efficiency score and covering the demands. Design/methodology/approach Covering location problems is considered a very important issue in the decision-making of organizations and companies. The purpose of these problems is to assign a set of demand points to a set of candidate locations so that optimal covering is provided for the demand points. Considering the efficiency of facility location with the help of DEA helps the decision-maker to reach more effective information and better analysis of the problem. Findings This paper applied the proposed models in the health centers of Shahrood City, so that each of the centers is considered a decision-making unit, and each of the decision-making units consists of three subunits that are connected in a series network. The primary results highlight the importance of the internal units beside the overall performance of healthcare centers. Originality/value Therefore, in this article, this paper develops two novel types of covering location problems joint with network data envelopment analysis. This paper proposes biobjective mixed integer programming models associated with the aforementioned development.

Improvement of Organizational Citizenship Behavior (OCB) through Strengthening Organizational Culture, Teamwork, Personality, and Decision Making

The purpose of the research is to produce strategies and ways to improve the Organizational Citizenship Behaviour (OCB) of private vocational school teachers, namely by strengthening the independent variables that have a positive effect on teacher OCB. These variables are Organizational Culture, Teamwork, Personality, and Decision Making. The optimal solution found is then used as a recommendation to related parties, namely teachers, principals, school supervisors, school management institutions and education agencies. The method used in this research is quantitative research using survey methods and path analysis techniques and SITOREM analysis to analyze indicators to determine optimal solutions in improving teacher OCB. The research was conducted on permanent foundation teachers (GTY) of private Vocational High Schools (SMK) in East Jakarta with a population of 381 teachers, with a sample of 195 teachers calculated using the Taro Yamane formula. The results of this study are that there is a positive direct effect of organizational culture, teamwork, personality, and decision making variables on OCB; there is a positive direct effect of organizational culture, teamwork, and personality on OCB; there is a positive indirect effect of organizational culture, teamwork, and personality on OCB through decision making.

From Data to Decisions: Validating Ocean Ecosystem Services Scale

Several studies address the main topic of research, Ecosystem Services. It is also proven that decision-making in organizations generally involves a decision-maker, who assumes internal responsibility for the results. However, when the decision is collective, we need to think about the context of governance. How to improve the decision by the governance involved in the decision-making process? When this decision is applied to Ocean Ecosystem Services, in particular, we need a parameter. Therefore, the proposed scale is an initial guide for decisions on the governance of ocean services ecosystems. In this article, the scale proposal with validation through classical linear regression, and supported by an artificial neural network, demonstrates the main variables that influence the decision and contribute to possible risk mitigations in terms of decisions.

Aesthetic Leadership as a Determinant of Organizational Integrity and Clinical DecisionMaking Effectiveness among Nurses

Aesthetic Leadership as a Determinant of Organizational Integrity and Clinical DecisionMaking Effectiveness among Nurses

Strategic decision-making in outsourcing: Towards a substantive theory of business streamlining in outsourced processes

Organizations are embracing the concept of outsourcing to avoid spending on skills that are needed intermittently. Studies have indicated that outsourcing has been accepted as a strategic move that will be unavoidable business practice in the future. However, there is no clear framework for strategic outsourcing that organizations can use to ensure success. This research utilizes exploratory and descriptive approaches to investigate outsourcing decisions in organizations and the basis of optimizing outsourcing practices. The qualitative aspect of the research involved interviewing of top managers of organizations to gain understanding of outsourcing decisions and challenges encountered in the process. The research employed inferential statistical analysis to draw conclusions from the data collected. The results indicated that outsourcing decisions are motivated by firms seeking operational efficiency. Most firms base their outsourcing tactics on the prior experiences, and there was high correlation between the number of times a firm has outsourced and outsourcing optimization. Also, the study finds out that technological complexity is a considerable factor when making an outsourcing decision. Incidentally, the study established a high correlation between outsourcing and operational efficiency. Organizations that had a propensity to outsource recorded high alignment with objectives and goals. The research validates the need for outsourcing optimization, and proposes a framework for effective outsourcing.

Factors Influencing Information Quality of Information Systems: A Systematic Literature Review

In today's digital era, information quality in information systems is essential for organizational effectiveness and decision-making. This systematic literature review aims to assess and synthesize factors influencing information quality across various systems, focusing on key dimensions such as reliability, accessibility, usability, accuracy, completeness, and timeliness. The existing literature is fragmented, lacking an integrated theory that comprehensively addresses the significance of information quality. Thus, a systematic review was conducted following the PRISMA framework to address this gap and provide evidence-based recommendations for research and practice. Studies were identified, screened, and selected from Scopus and Web of Science. After an initial search using specific keywords, a total of 1,548 articles were found that contained specified terms or strings in various combinations. Of these, 31 studies were chosen for full review based on predefined inclusion and exclusion criteria. The analysis was organized into three primary themes: i) Core Information Quality Factors, ii) Synergizing Information Quality with System and Service Quality, and iii) Impact of Information Quality on User Satisfaction and Organizational Outcomes. The results emphasize the significant role of high information quality in enhancing user satisfaction and operational efficiency. Different industries prioritize various quality dimensions according to their specific needs. Therefore, this review elucidates the imperative function of good quality information in reinforcing information systems' proper functioning, calling for empirical studies to develop holistic frameworks that incorporate multiple dimensions and impact analysis across different domains.

성과 피드백이 기업의 R&D 활동에 미치는 영향에 대한 성과주의 제도의 조절 효과

This study examines the moderating effect of performance-based pay systems on the relationship between performance feedback and research and development (R&D) activities. When a firm’s performance either falls short of or exceeds aspiration levels, such performance feedback influences organizational decision-making by increasing or decreasing search behaviors. Prior research has highlighted the significant impact of performance feedback on R&D activities, which are critical to a firm’s long-term survival and growth, despite their inherent uncertainty and risk. However, the role of reward systems—which significantly influence employee motivation and attention allocation—in shaping the relationship between performance feedback and R&D activities remains underexplored. This study argues that performance-based pay systems, widely adopted by Korean firms since the late 1990s, pressure employees to prioritize short-term performance and reinforce their risk-averse tendencies, potentially hindering R&D decisions. An analysis of panel data from Korean manufacturing firms between 2009 and 2017 reveals that firms with performance-based pay systems tend to reduce R&D activities more significantly than their counterparts when performance falls short of aspiration levels. Similarly, these firms are more likely to decrease R&D activities even when their performance exceeds aspiration levels. The findings underscore the importance of incorporating organizational reward systems into performance feedback models and provide theoretical insights into how performance-based pay systems indirectly influence R&D activities by shaping responses to performance feedback. Practically, the study emphasizes the need for strategically designed reward systems to prevent unintended reductions in R&D activities in response to performance feedback.

Empowering stakeholder engagement and decision-making in future nuclear organisations: a multilevel research framework for challenges and opportunities

Purpose This study aims to present a comprehensive research framework designed to assess stakeholder perceptions in the nuclear power plant (NPP) industry, with a focus on the unique context of the Al Barakah NPP in Abu Dhabi, United Arab Emirates. The framework combines a thorough literature review, primary data collection methods and strategic action planning to facilitate stakeholder engagement and drive progress in the industry. Design/methodology/approach To develop the framework, an extensive review of relevant literature was conducted, identifying gaps and incorporating insights from sectoral reports, governmental documents and scholarly works. Primary data collection was then carried out using an online survey administered through Google Forms. The survey instrument was carefully designed, adhering to established guidelines and incorporating closed-ended questions, Likert scales and multiple-choice formats. Pilot-testing of the survey was conducted among the general public residing in the vicinity of the Al Barakah NPP. Findings The multi-level research framework enables a systematic assessment of stakeholder perceptions in the NPP industry. Through the analysis and synthesis of collected data, a strategic approach and customised managerial action plan can be formulated, tailored to the specific context of the NPP. This approach encourages stakeholder involvement and plays a vital role in driving industry advancements. Practical implications The proposed framework offers a valuable tool for NPP stakeholders, policymakers and industry professionals to gather and analyse stakeholder perceptions effectively. It empowers informed decision-making, fosters stakeholder engagement and supports the development of strategic actions that address concerns and propel progress in the NPP industry. Originality/value This study contributes to the existing literature by presenting a comprehensive research framework specifically designed for assessing stakeholder perceptions in the NPP industry. By integrating literature review, primary data collection and strategic action planning, it provides a holistic approach to comprehend stakeholder perspectives and promote sustainable development in the nuclear energy sector.

Business Group Affiliation and Board Independence in India: The Effects of Structural and Situated Attention

ABSTRACTResearch Question/IssueThis study examines how business group affiliation shapes firm attention and consequently influences firms' compliance with board independence requirements.Research Findings/InsightsUsing a longitudinal sample of Indian listed firms, we find that group‐affiliated firms are more likely to comply with board independence requirements than nongroup firms, especially when the affiliated firm is larger or when a greater proportion of firms in the business group has adopted an independent board structure. However, the likelihood of compliance in group‐affiliated firms is subject less to the influence of the industry compliance norm. We also document that group‐affiliated firms are less sensitive to the influence of the industry task environment than stand‐alone firms. Other things being equal, the influences of industry complexity, munificence, and dynamism on compliance are smaller in group affiliates.Theoretical/Academic ImplicationsOur study contributes to the attention‐based view by extending the structural attention argument from organizational structures within firm boundaries to organizational forms across firm boundaries. We argue that the network structure of business groups shapes affiliated firms' attention focus and consequently affects their compliance patterns. We also highlight the joint effects of structural and situated attention on shaping organizational decisions. We reveal that the interplays of business groups' organizational form and industry contexts give rise to distinct compliance patterns between affiliated and unaffiliated firms and among different types of group‐affiliated firms. As such, we supplement prior corporate governance literature by stressing the influences of inter‐organization networks and industry task environment on board structure.Practitioner/Policy ImplicationsOur study indicates that inter‐organizational networks affect compliance with corporate governance regulations. Thus, the government could utilize inter‐organizational relationships and peer influence to encourage compliance. Our study also highlights the impact of industry environments and business group structure on board composition and managers' cognitive limitations that prevent them from attending to all situational cues. Thus, it is essential for managers to allocate their scarce attention to scanning various domains of their firms' external environments and internal circumstances when making strategic and corporate governance decisions.

Effect of transformational leadership on employees’ shared goals during merger and acquisition: moderating roles of organizational support and participative decision-making

PurposeDespite the benefits that firms obtain from merger and acquisition (M&A), this strategy frequently poses a significant challenge for management in encouraging employees of the acquired firm to develop shared goals with the new organization. This research analyzes the effect of transformational leadership by department managers in the acquiring firm on the degree to which employees in the acquired firm develop shared goals. We also examine whether the effect of transformational leadership on shared goals could be moderated by organizational support and employee participation in decision-making.Design/methodology/approachThis research was conducted using the case of a firm in the power and energy sector that was undergoing M&A. Survey data were obtained from 203 employees and their department managers to avoid common method bias. The data were analyzed using partial least squares structural equation modeling.FindingsWe found that employees in the acquired firm who worked for the department managers of the acquiring firms who demonstrated transformational leadership were more likely to adopt shared goals than those who did not. Moreover, the moderating effect analysis shows that transformational leadership had a greater effect on shared goals when employees perceived that they received a high level of organizational support. On the contrary, transformational leadership had a weaker effect on shared goals when employees actively participated in decision-making.Practical implicationsTransformational leadership is the leadership practice that the management of the acquiring firm needs to apply to employees, who are a critical part of the firm’s human capital, when they manage the M&A activities. The management also needs to demonstrate to the employees that the acquiring firm cares about the employees’ well-being and has sincere concern for them throughout and after the M&A process. Despite the transformational leadership practice’s essential role, participative decision-making is another management practice that should be implemented to reduce employees’ reliance on the management’s transformational leadership to persuade them to adopt shared goals, which might be essential when the transformational leadership practice cannot be effectively implemented.Originality/valueOur results regarding the moderating effects of perceived organizational support and participative decision-making add some new knowledge to the theory by showing that the management’s implementation of transformational leadership during M&A will need to consider other management practices that may either intensify or weaken the benefit that employees may gain from the management’s transformational leadership.

“I am putting my fear on them subconsciously”: a qualitative study of contraceptive care in the context of abortion bans in the U.S.

BackgroundSince the Dobbs vs. Jackson Women’s Health Organization decision in June 2022, providers throughout the U.S. have been navigating the shifting legal landscape of abortion bans, which diminish the delivery of evidence-based healthcare. The Dobbs decision has had a detrimental impact on medical training, the physician–patient relationship, and provision of medical care. However, few studies have captured the effects on providers in adjacent fields, including contraceptive care. Our objective was to examine the impact of Dobbs on contraceptive care.MethodsWe conducted semi-structured in-depth interviews (August 2022–July 2024), with 41 contraceptive healthcare providers across the US, with the majority (63%) in abortion restrictive states. We utilized deductive thematic analysis to assess providers’ practice changes and experiences related to contraceptive services.ResultsIn reaction to the Dobbs decision, providers noted increased requests for contraception, especially for highly effective methods. Providers worried that certain methods, such as IUDs or emergency contraception, would become restricted, and mentioned advance provision of pills and other ways that they would try to ensure supplies. Providers also discussed that their patients were worried about threats to contraception, including for adolescents. Some expressed concern, however, that the abortion bans may prompt providers to overemphasize high-efficacy methods with directive counseling. Providers shared that it was stressful to practice in contexts of uncertainty, with shifting abortion policies affecting contraceptive care, including emergent needs such as providing contraceptive services to out-of-state patients before they go home. Several providers shared that they felt an increased importance of their role in their communities, and a deepened commitment to advocate for their patients.ConclusionsAbortion restrictions profoundly impact providers’ contraceptive counseling and care. The effects of Dobbs on providers and their clinical practices underscore providers' legally precarious position in today’s reproductive health landscape. Attention to contraceptive access and person-centered care has become a salient public health need across the U.S. The long-term impacts of limited reproductive rights may stretch an already under-resourced healthcare system and further emphasize moral pressures.

AI-empowered KM processes for decision-making: empirical evidence from worldwide organisations

PurposeThis paper aims to provide empirical evidence on adopting artificial intelligence (AI), including generative AI, in knowledge management (KM) processes and its impact on organisational decision-making. Specifically, the study addresses three key research questions: RQ1: How is (generative) AI adopted within KM processes in organisations? RQ2: What factors influence the adoption of AI in these processes, either facilitating or inhibiting it? RQ3: How does AI adoption in KM processes affect organisational decision-making?Design/methodology/approachAn explorative investigation has been conducted through semi-structured interviews with KM and AI experts from a worldwide sample of 52 mostly private, large and for-profit organisations. Interviews have been analysed through a mixed thematic analysis.FindingsThe study provides an original framework in which the three investigated concepts are interconnected according to a dual relationship: linear and retroactive and 20 factors affecting AI adoption within KM processes.Practical implicationsThe provided model guides managers in improving their organisational decision-making through AI adoption in KM processes. Moreover, according to the rational decision-making model, the authors propose a six-step systematic procedure for managers.Originality/valueTo the best of the authors’ knowledge, this is the first study that simultaneously addresses AI, KM and decision-making and provides an integrated framework showing the relationships between them, allowing organisations to better and practically understand how to ameliorate their decision-making through AI adoption in KM processes.

Moral Decision-Making in Organizations

Moral Decision-Making in Organizations

The Evolution of Data Visualization Tools and Their Impact on Business Decision-Making : A Historical Analysis

This article examines the transformative evolution of data visualization tools and their profound impact on business decision-making processes. Through a comprehensive analysis of historical developments, theoretical frameworks, and technological advancements, the article explores how visualization tools have progressed from basic manual charts to sophisticated AI-powered analytical platforms. The investigation encompasses the cognitive foundations of visual information processing, the emergence of first-generation Business Intelligence tools, and the current landscape of modern visualization platforms. Particular attention is given to the integration of artificial intelligence in data visualization, including automated generation, pattern recognition, and predictive analytics capabilities. The article presents both quantitative and qualitative assessments of these tools' impact on organizational decision-making, highlighting significant improvements in decision speed, accuracy, and user engagement. The article reveal substantial benefits in terms of ROI, decision-making efficiency, and organizational adoption patterns. The article concludes by examining emerging trends, including the potential of extended reality technologies and edge computing, while acknowledging current limitations and providing recommendations for future research directions in this rapidly evolving field.

A Study on the Rational Decision-Making Process of Vessel Organization—Focusing on Cases of Vessel Accidents

Vessel organizations are exposed to the risk of accidents due to the limited experience and intuition of the top decision makers in the organization in the special environment of the sea. This study aims to provide a direction for sustainable and rational decision-making in vessel organization through decision making process theory and case studies of actual vessel accidents. The results obtained from the actual case studies show that all three vessel accidents were caused by the arbitrary decision of the decision maker based on the Garbage Can model. This can be attributed to the closed nature of the vessel’s organization, which requires a decision-making process that is a hybrid of the Carnegie Decision model and Management Science model. Implications include the introduction of a ‘My Ship’ system, the de-subjectivization of top decision makers, situational awareness, and the need to provide top decision makers with the context and information relevant to their decisions. Limitations of this study include the fact that the case study was conducted only on Korean-flagged vessels and the study was limited to vessel accidents that occurred in the waters off Korea, China, and Japan, which limits the generalizability of the findings. In order to overcome these limitations, it would be interesting to conduct a follow-up study to include vessel accidents of different nationalities or to further investigate the characteristics of the decision-making process in vessel accidents by country.

Catastrophic Health Expenditures for In-State and Out-of-State Abortion Care

Most US individuals who access abortion care pay out of pocket due to insurance coverage restrictions on abortion. More research is needed on the financial and psychological burdens of abortion seeking, particularly for those traveling across state lines for care. To estimate the proportion of patients seeking abortion who incur abortion-related catastrophic health expenditures (CHEs), assess whether CHE differs between those seeking care in state vs out of state, and examine the association of CHE with mental health symptoms. In this cross-sectional study conducted before the Dobbs v Jackson Women's Health Organization decision, surveys were administered between January and June 2019 among individuals aged 15 to 45 years seeking abortion in 4 clinics located in abortion-supportive states (California, Illinois, and New Mexico). Participants completed self-administered questionnaires while awaiting their abortion appointment. Analyses were conducted from November 2023 to April 2024. Travel for abortion care, categorized as either out of state or in state based on participants' state of residence and the clinic location. Self-reported abortion care costs and additional non-health care costs (eg, transportation, accommodation, and missed work), which were considered catastrophic if they were 40% or greater of participants' ability to pay (defined as monthly income remaining after meeting subsistence needs). Multivariable regression analyses were conducted to examine associations between CHE, out-of-state travel for abortion care, and mental health symptoms including stress, anxiety, and depression. Among the 675 participants included in the analytic sample, mean (SD) age was 27.33 (6.27) years; most were in their 20s (374 [55%]), and all but 196 (29%) sought abortion before or at 12 weeks' gestation. A total of 285 participants (42%) were estimated to incur abortion-related CHEs, which was associated with anxiety (APR, 1.13; 95% CI, 1.07-1.19) and depression (APR, 1.25; 95% CI, 1.12-1.39). Of people traveling from out of state (212 [31%]), more were likely to incur CHEs (138 [65%]) compared with those seeking care in state (147 of 463 [32%]) (APR, 2.24; 95% CI, 1.67-3.00). In this cross-sectional study of US patients seeking abortion, many individuals and their households were estimated to incur CHEs, particularly those traveling from out of state. The financial and psychological burdens of abortion seeking have likely worsened after the Dobbs decision, as more people need to cross state lines to reach abortion care. The findings suggest expansion of insurance coverage to ensure equitable access to abortion care, irrespective of people's state of residence, is needed.

The anatomy of clinical decision-making: aligning AI design with ICU routines

PurposeIn the face of numerous explanations for why AI-driven decision support systems (DSS) have failed to deliver on their promise of improving organizational decision-making, this paper problematizes the under-theorized mismatch between the design of DSS and the actual decision-making processes that the technology is supposed to support. We examine this mismatch by studying the implementation of a DSS in the intensive care unit (ICU) of a large academic hospital.Design/methodology/approachBased on 27 months of ethnographic fieldwork, we contend that the studied DSS was designed on the assumption that individual intensivists are responsible for making life-critical discharge decisions at one particular moment in time.FindingsHowever, our study of actual decision-making practices reveals that discharge decision-making is instead a protracted process, involving multiple actors fragmented across time and space. To account for these complexities, we advocate for a “dynamic routines” perspective, which highlights the actual patterns of action pursued throughout a clinical decision-making process.Originality/valueOur application of this perspective contributes to a more granular understanding of discharge decision-making, which can help future DSS designers better grasp the peculiarities and complexities—or “anatomy”—of the decision-making process. We also suggest integrating an “anticipatory ethnographic approach” into the design and pre-implementation phases of future DSS to help bridge the current gap between design assumptions and actual decision-making practices.

Implementing an unlearning approach to combat counter-knowledge in multiple sclerosis

ABSTRACT In the social domain, the term counter-knowledge has been used to refer to misinformation, gossip, rumours, and conspiracy theories that masquerade as knowledge. An individual’s assimilation of such counter-knowledge can lead to inappropriate individual behaviours and organisational decision-making. This study proposes a framework for investigating the relationship between counter-knowledge and learning myopia at the individual level in the healthcare domain, focusing on Multiple Sclerosis (MS). Given that those suffering from MS can experience symptoms leading to both a slowing down of information processing and a limited capacity. It is argued that these symptoms are likely to lead to exacerbating other symptoms, such as anxiety and depression. In addition to investigating how social counter-knowledge results in individual counter-knowledge, the research proposes a framework for understanding the challenges of implementing machine unlearning approaches, and a set of strategies to disrupt this linkage is also proposed.

Site Reassignment for Mobile Outreach Teams: Investigating the Effectiveness of Decentralized Decision Making

Problem definition: United Nations Sustainable Development Goal (SDG) 3.8 states that health coverage should be universal by 2030. This is challenging in rural and poor areas. To address this challenge, mobile outreach teams of healthcare workers visit a fixed set of remote sites to provide healthcare services. Because of dynamics in demand and supply, once-rational site-to-team assignment decisions can become far from optimal over time. This paper considers the problem of reassigning sites to teams to maximize effectiveness. Solving this problem through a central planner does not fit the context: outreach teams commonly have a high degree of decision-making autonomy. We study a decentralized approach where subsets of teams collaborate in a series of team meetings to reassign sites. The key question for decision makers is whether and when such an approach is effective. Methodology/results: We propose a mixed-integer programming model for centralized site reassignment. We extend this model to represent the decentralized approach and develop a set of simple decision rules for this approach. We use empirical data from six country outreach programs of the nongovernmental organization MSI Reproductive Choices. Our results suggest that, when properly designed, decentralized decision making performs close to centralized decision making, and even outperforms it in the case of inaccurate information at the central level. The finding remains valid when demand and supply fluctuate, and is insensitive to the chosen objective. Managerial implications: Humanitarian organizations currently deploy mobile outreach teams to provide a wide variety of health services. We present several useful insights for decision makers in humanitarian organizations when making design choices, taking account of context. In particular, we show that decentralized site reassignment provides a feasible and effective alternative to centralized approaches in many contexts. Supplemental Material: The online supplement is available at https://doi.org/10.1287/msom.2021.0437 .